Active NPI
Eric C Gebhart, B.S., CSAC
- Addiction (Substance Use Disorder) Counselor
- New Glarus, WI
National Provider Identifier
1821245192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15274-132
- Practice address
- 1307 State Road 69
New Glarus, WI 53574-9328 - Phone
- (608) 527-2426
- Fax
- (608) 527-1939
- NPI assigned
- Aug 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15274-132 | WI | Primary |
Addresses
Primary practice location
1307 State Road 69
New Glarus, WI 53574-9328
Mailing address
1307 State Road 69
New Glarus, WI 53574-9328
Phone (608) 527-2426
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eric@lifesabeachcounselingllc.com | ||
| Direct Messaging Address | eric@lifesabeachcounselingllc.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15274-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life'S a Beach Counseling LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| County of Green | Past | Accepting new patients |
Locations
1307 State Road 69
New Glarus, WI 53574
Phone (608) 527-2401
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- New Glarus, WI
- NPI 1760005623
Addiction (Substance Use Disorder)
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Monroe, WI
- NPI 1992925085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1821245192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 STATE ROAD 69",
"city": "NEW GLARUS",
"state": "WI",
"postal_code": "535749328",
"telephone_number": "608-527-2426",
"fax_number": "608-527-1939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 STATE ROAD 69",
"city": "NEW GLARUS",
"state": "WI",
"postal_code": "535749328",
"telephone_number": "608-527-2426",
"fax_number": "608-527-1939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEBHART",
"first_name": "ERIC",
"middle_name": "C",
"credential": "B.S., CSAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-19",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15274-132",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eric@lifesabeachcounselingllc.com",
"affiliation": "N",
"address_1": "1307 State Road 69",
"city": "New Glarus",
"state": "WI",
"country_code": "US",
"postal_code": "535749328",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eric@lifesabeachcounselingllc.com",
"affiliation": "N",
"address_1": "1307 State Road 69",
"city": "New Glarus",
"state": "WI",
"country_code": "US",
"postal_code": "535749328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New Glarus, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.